title: Therapeutic touch is not therapeutic for procedural pain in very preterm neonates: a randomized trial.
abstract: BACKGROUND
  Preterm neonates below 30 weeks' gestational age undergo numerous painful procedures. Many management approaches are not appropriate for this population. Therapeutic Touch, an alternative approach based on the theory of energy medicine, has been shown to promote physiological stability in preterm neonates and reduce pain in some adult studies. The objective was to determine whether Therapeutic Touch is efficacious in decreasing pain in preterm neonates.
  
  
  METHODS
  Infants < 30 weeks' gestational age participated in a randomized control trial in 2 level III neonatal intensive care units. All evaluations, analyses, and heel lance procedure were conducted with only the therapist knowing the group assignment. Immediately before and after the heel lance procedure, the therapist performed nontactile Therapeutic Touch (n = 27) with infant behind curtains, leaving the curtained area for the heel lance, performed by another. In the sham condition (n = 28), the therapist stood by the incubator with hands by her side. The Premature Infant Pain Profile was used for pain response and time for heart rate to return to baseline for recovery. Heart rate variability and stress response were secondary outcomes.
  
  
  RESULTS
  There were no group differences in any of the outcomes. Mean Premature Infant Pain Profile scores across 2 minutes of heel lance procedure in 30-second blocks ranged from 7.92 to 8.98 in the Therapeutic Touch group and 7.64 to 8.46 in the sham group.
  
  
  CONCLUSIONS
  Therapeutic Touch given immediately before and after heel lance has no comforting effect in preterm neonates. Other effective strategies involving actual touch should be considered.
authors.affiliation: School of Nursing, McGill University, Montreal, QC. celeste.johnston@mcgill.ca
authors.forename: Celeste
authors.initials: C
authors.lastname: Johnston
authors.forename: Marsha
authors.initials: M
authors.lastname: Campbell-Yeo
authors.forename: Bonnie
authors.initials: B
authors.lastname: Rich
authors.forename: Julie
authors.initials: J
authors.lastname: Whitley
authors.forename: Francoise
authors.initials: F
authors.lastname: Filion
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cogan
authors.forename: Claire-Dominique
authors.initials: CD
authors.lastname: Walker
mesh_terms: D005260:Female; D005865:Gestational Age; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010146:Pain / Q000503:physiopathology / Q000534:rehabilitation*; D010147:Pain Measurement; D018709:Statistics, Nonparametric; D019124:Therapeutic Touch / Q000379:methods*; D016896:Treatment Outcome